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Chapter 3: Adverse Reactions

1. Name four classifications of adverse drug reactions. A. Toxic Reaction: - Extension of the pharmacologic effect resulting from effect on target organs, B. Side Effect: -Dose- related reactions - Drug acts on non target organs C. Idiosyncratic Reaction: - Abnormal Drug Response D. Drug Allergy: - Immunologic Response
2. Describe the problem with identifying teratogenic agents. - Although more information is now available about safety of certain drugs in pregnant women, sufficient information is still lacking. Most or all of the drugs always put a sentence where it states and leaves clear that not enough studies have been done on that specific drug. Most drugs used in dentistry are considered safe.
3. Describe the types of adverse reactions.
- Type A Reactions -Predictable: - Cytotoxic reactions - Most extension of drug's therapeutic effect. - Mainly owing to formation of unstable or reactive metabolites from abnormality of metabolism or excretion. - Leads to saturation of hepatic enzyme systems. - Drug- Drug interactions - Pharmacodynamic drug-drug interactions - Characterized as pharmacologic, physiologic, or chemical interactions, or drug-related receptor alterations. - Pharmacokinetic drug-drug interactions - Changes in plasma levels of a drug as a result of a rate alteration of absorption, distribution, metabolism, and excretion. - Drug- Food interactions - Interactions affecting absorption - Interactions affecting metabolism - Interactions affecting excretion - Drug-Disease interactions - Pharmacodynamic interactions - Intended effect produced by a given plasma level of a drug is altered in the presence of another drug - Opioids Vs. Naloxone

- Pharmacokinetic interactions - The duration and intensity of a drug's action is based on the

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